Sunday, August 26, 2012

The second year of medical school is under way and the first course on the lineup is endocrinology which covers the glands: the pituitary on the brain, the adrenals on top of the kidneys, the gonads, the thyroid, and pancreas. The course covers, in essence, how one part of the body releases chemicals and how those chemicals affect another part of the body as well as what happens when things go wrong with too much or too little of the hormone. The course has been pretty easy, but that makes for higher test averages and we all know that I can only be satisfied if the number of people beneath me is large enough.

Administration projected a cost of living for second year that gives those relying solely on loans about five thousand dollars less than last year. I have heard rumbles in the ranks. Some of my favorite include:

"Well, I know we're poor, but I don't want to look like I'm poor."

Them: "I guess we're not going to be able to afford food."

Me: "You are on food stamps; you don't ever pay for your food."

Them: "Yeah, well, I guess we won't be able to eat out nearly as much."

"I guess my parents are just going to have to give me more money to cover rent. They are already sacrificing to give me the money they do."

Giving up a fourth of your yearly income is difficult and the difficulty has manifested itself in some interesting ways. The school recently contracted with the maker of Pathoma, a pathology and USMLE Step 1 review, for offering the program for about eighty dollars instead of the normal one hundred. The high recommendations of other students created a demand for acquiring the program illegally for free. Unfortunately, the only people I know for sure that have it are the people I talk to the most - my close, LDS, temple recommend-holding friends. The officer training says, "Tolerating unethical or illegal behavior makes you equally guilty."

Doing what I know is right means reporting my friends to administration, come what may. More of the officer training says, "Lord, when I am wrong, make me willing to change; when I am right, make me easy to live with. So strengthen me that the power of my example will far exceed the authority of my rank." (Pauline H. Peters)

Sunday, August 5, 2012

I'm plugged in again. I've been in Alabama for almost five weeks for Commissioned Officer Training. I didn't really know what to expect when I went in and that's probably a protective mechanism the Air Force has built in to the recruiting system. During the first two weeks there was a lot of yelling. The drill officers yelled at us to get in step, cup hands as we marched, swing our arms six inches to the front and three to the rear, gently brushing the pants at the apex of the arc, etc. The military training instructors yelled at us to eat faster at a position of 'modified attention' with the heals of our feet touching flat on the ground at 45 degrees, bending slightly from the waste to avoid spilling food, establishing the rules for each of the four positions per table, no talking, no looking around,etc.

Then we were assigned flight commanders for classroom instructions. There were procedures for when the flight commanders enters or exits the room, daily uniform inspections, asking questions, and getting to various parts of campus. Then there were dorm room inspections in which shirts, socks, and gear had to be folded just so and in the reserved parking space; pants had to be hung with the waist on the left side of the hanger, fly facing towards the door, waist and ankle bands flush, and items evenly spaced on the rack with empty hangers to the right.

One guy received the Heimlich maneuver from eating too fast, some suffered from dehydration, almost a third visited a doctor during the month and were put on medical profile (a status that allowed them to avoid marching and physical conditioning), and most got blisters at one point or another.

The physical conditioning was surprisingly the easiest part of the program. I feel like I was in better shape when I left for COT than I am now at the end. The early mornings and packed days made it difficult to stay awake during the auditorium lectures held in 'the big red bed' so named after the crimson colored chairs we received lectures in.

My flight commander put the fear of COT into everyone during the first week, but became the most congenial and liked from the third week on. He was something of a Renaissance man having been a paramedic (at ground zero in New York on 9-11), a chaplain in the air force, a nurse, has sung on Broadway, is a published author, and teaches new officers when he can fit it in.

The classroom lectures covered topics like how officers fill out reports for enlisted members, leadership, teamwork, the organization of the Department of Defense, and various theories on justifiable war. The class during which I was the most incredulous was the two hours we spent on how to write bullet points. As an officer you show interest in your career if you provide your supervisor what you want included in your yearly performance report. The language of the performance report is unique to the military. To give you an idea of how the mundane can sound vital:I went to the store, bought groceries, and didn't have to go back for a week.
BecomesProactively engaged commodity acquisition, developed logistics strategy, fed local family of 5 for 7 days!

It requires reading between the lines to figure out what really happened and I am not completely convinced that there is not a certain amount of deception in verbosity. Thus, when the Pentagon labels the war on Libya as an 'time-limited, scope-limited kinetic military action,' you can respond with, if shopping is commodity acquisition then a war by any other name is still a war.

It was a difficult month, but near the end I came to understand the purpose of the rough treatment and became reconciled with my time there. The yelling was nothing personal and our flight commander told us right before graduation that he hated doing it and always went home those first few days of a new COT class feeling pretty low. He explained the purpose of it by showing us a 50 minute lecture that General Welsh gave at the Air Force Academy last year.

Defining the Relationship

Family Practice - I love the steady, dependable companionship. You know when to give me space, but be careful that your monotony doesn't come between us.

Surgery - The thrills make me tingle, but you are high maintenance and clingy. Sometimes I need to leave you to miss you.

Nephrology - You are varied and never overreact, and I enjoy your puzzling problems. I like you, but your dad, Internal Medicine, wants me to pledge allegiance to him before he considers me worthy of you.

OB/Gyn - You have a little bit of every something that is wrong with life: strong opinions, strange opinions, PMS, menopause, hormones, promiscuity, and STDs.

Peds - You are the same person as OB/Gyn. I am not fooled by the makeover. You traded STDs for runny noses and pregnancy checks for well-child visits.